Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Matthew Ethan Johnson, PA-C

Individual provider Physician Assistant · NPI 1023398302

Mr. Matthew Ethan Johnson, PA-C is a Physician Assistant in State College, Pennsylvania. Qualified in 2011, 15 years ago. Practices with Susquehanna Physician Services, a 612-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Connecticut and Pennsylvania.

Years since qualifying
15
Licensed in
CT, PA
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

164 Greenview Dr Ste 345
State College, PA 16803-2106
Phone: (814) 234-7599
Fax: (814) 237-2126
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 24 Stevens St, Norwalk, CT 06856 — (203) 852-2189
  • 700 High St, Williamsport, PA 17701-3100 — (703) 585-0221

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (PA)
Physician Assistant Taxonomy 363A00000X · Licence 2609 (CT)

Record details

NPI number1023398302
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 18, 2011
Last updated in NPPESSeptember 26, 2025
Certification dateSeptember 26, 2025
Mailing address155 Wellness Way, State College, PA 16803-6702

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Susquehanna Physician Services — 612 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in State College